Year 2021 / Volume 113 / Number 1
Original
Endoscopic ultrasound-guided ethanol ablation for the management of a symptomatic pancreatic insulinoma

48-51

DOI: 10.17235/reed.2020.7109/2020

Gabriel Mosquera-Klinger, Jhon Jaime Carvajal,

Abstract
Introduction: pancreatic insulinoma is a sporadic, usually benign, frequently solitary tumor that is smaller than 20 mm. When it is functioning, patients present with symptoms of hypoglycemia secondary to insulin hypersecretion. The diagnosis is clinical, with biochemical and radiological confirmation. Surgery is the management of choice, although endoscopic ultrasound-guided ablation is currently being developed. Material and methods: we present a prospective case series of pancreatic insulinoma patients with symptoms of severe hypoglycemia, who were treated with endoscopic ultrasound-guided ethanol ablation as an alternative to surgical management. Results: technical and clinical success was achieved in all cases and there were no complications associated with the procedure. Conclusion: the treatment of symptomatic insulinoma by endoscopic ultrasound-guided ethanol ablation could be a safe and effective alternative to surgical management in non-surgical patients or those who refuse surgery.
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References
1. Tucker ON, Crotty PL, Conlon KC. The management insulinoma. British Journal of surgery 2006;93:264-275.
2. Service FJ, McMahon MM, O’Brien PC, Ballard DJ. Functioning insulinoma: incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc 1991; 66: 711-719.
3. Goldberg SN, Mallery S, Gazelle GS, et al. EUS-Guided radiofrequency ablation in the pancreas: results in a porcine model. Gastrointest endosc 1999;50:392-401.
4. Wu Y, Tang Z, Fang H, et al. High operative risk of cool-tip radiofrequency ablation for unresectable pancreatic head cancer. J Surg Oncol 2006;94:392-5.
5. Spiliotis JD, Datsis AC, Michalopoulos NV, et al. Radiofrequency ablation combined with palliative surgery may prolong survival of patients with advanced cancer of the pancreas. Langenbecks Arch Surg 2007;392:55-60.
6. Elias D, Baton O, Sideris L, et al. Necrotizing pancreatitis after radiofrequency destruction of pancreatic tumours. Eur J Surg Oncol 2004;30: 85-7.
7. Lakhtakia S, Ramchandani M, Galasso D, et al. EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos). Gastrointest endosc 2016;83(1):234-239.
8. Waung J, Todd J, Keane MG, et al. Succesful management of a sporadic pancreatic insulinoma by endoscopic ultrasound-guided radiofrequency ablation. Endoscopy 2016;48:E144-E145.
9. Limmer S, Huppert PE, Juette V, et al. Radiofrequency ablation of solitary pancreatic insulinoma in a patient with episodes of severe hypoglycemia. Eur J Gastroenterol Hepatol 2009;21:1097-101
10. Pai M, Habib N, Senturk H, et al. Endoscopic ultrasound guided radiofrequency ablation for pancreatic cystic neoplasms and neuroendocrine tumors. World J Gastrointest Surg 2015;7:52-9.
11. Rossi S, Torello Viera F, Ghittoni G, et al. Radiofrequency ablation of pancreatic neuroendocrine tumors; a pilot study of feasibility, efficacy, and safety. Pancreas 2014;43:938-45.
12. Signoretti M, Valente R, Repici A, et al. Endoscopy-guided ablation of pancreatic lesions: Technical possibilities and clinical outlook. World J Gastrointest Endosc 2017; 9(2):41-54.
13. Dabkowski K, Gajewska P, Walter K, et al. Succesful EUS-guided ethanol ablation of insulinoma, four-year follow-up. Case report and literature review. Endokrynologia Polska 2017;68 (4): 472-479.
14. Qin Sy, Lu Xp, Jiang Hx. EUS-guided ethanol ablation of insulinomas: case series and literature review. Medicine (Baltimore). 2014; 93(14): 1-5.
15. Paik WH, Seo DW, Dhir V, et al. Safety and Efficacy of EUS-Guided Ethanol Ablation for Treating Small Solid Pancreatic Neoplasm. Medicine (Baltimore). 2016; 95(4): e2538
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Mosquera-Klinger G, Carvajal J. Endoscopic ultrasound-guided ethanol ablation for the management of a symptomatic pancreatic insulinoma. 7109/2020


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Publication history

Received: 05/04/2020

Accepted: 11/05/2020

Online First: 23/11/2020

Published: 11/01/2021

Article revision time: 34 days

Article Online First time: 232 days

Article editing time: 281 days


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